Project Summary With the recognition of developmental origins of adult disease, there is a strong need to train physician scientists who will address such fundamental mechanisms of disease and translate these findings to the care of critically ill newborns aiming to have a sustained, life-long impact on human health. The Harvard Neonatal- Perinatal Medicine Program has a >40 year history of training physician scientists who now lead national and international programs in academic neonatology. We are proud of our training history in that >70% of our graduates (>2.5x the national average) become academic neonatologists. Our large pool of eligible applicants combined with highly accomplished mentoring faculty in the scientific community of Harvard Medical School (HMS) and its four training hospitals allows us to train top candidates in cutting edge basic, translational, clinical, and health outcomes research. Since neonatology is not an organ-specific training discipline but encompasses the study of mechanisms and processes of organ development, perinatal injury, growth and repair, our research and career training is broadly focused in three core disciplines that represent strengths of the Harvard Program and define critical areas in need of new knowledge for this particularly vulnerable population: 1) The study of molecular, cellular, and epigenetic mechanisms of normal development and perinatal injury; 2) Investigation in neonatal genomics to uncover the genetic basis of complex disorders by combining gene sequencing with model systems to reveal genotype-phenotype correlations and develop precision medicine-based therapeutic strategies; 3) Training in regenerative medicine with stem cell and gene therapy-based studies to treat neonatal diseases at a critical time of development, aiming to achieve a sustained, life-long impact. The Program's structured research training will instill the skills and knowledge base to address these critical areas in newborn biology and perinatal health outcomes. We incorporate highly accomplished senior faculty at the fore front of science along with junior faculty as `mentors in training', thus providing abundant opportunities for cross fertilization. A mentoring program and scholarship oversight committee is assembled for each trainee to provide mentoring in scientific and career development. Didactic course is required for both basic and clinical research training and supplemented with relevant seminars, a course in the responsible conduct of research as well as an annual research symposium. Trainees in clinical or health outcomes research enroll in the HMS Clinical Effectiveness program and most obtain a Master's Degree in Medical Science or Public Health. Advisory committees of national experts provide on-going advice on candidate and mentor selection, scholarly progress, and overall success. Strategies are in place for the recruitment of minority candidates to ensure a diversity of trainees [5/20 (25%) current fellows came from underrepresented groups]. We are committed to continue to train and equip trainees with tools to advance and move independently into successful careers as investigators and leaders in Neonatal-Perinatal Medicine.